obstetrics Flashcards
(162 cards)
1
Q
pelvis uterus a t what age of pregnancy
A
12 weeks
2
Q
cardiovascular changes in pregnancy(4)
A
Increase cardiac output
increase haert rate
increase stroke volume
decrease BP
3
Q
systolic murmur and S3 during pregnancy
A
normal
4
Q
diastolic murmur in pregnancy
A
abnormal
5
Q
thyroid hormone in pregnancy
A
high total and bound T3 T4
6
Q
role of HPL human placental lactogen
A
acts as insulin antagonist to maintain fetal glucose levels
7
Q
why acid reflux during pregnancy
A
decrease gastro esophageal sphincter tone
8
Q
why constipation in pregnancy(2)
A
decrease large bowel motility
increase water reabsorbtion
9
Q
why pregnant women are prne to gallstones
A
because of high biliary cholesterol saruration
10
Q
anemia in pregnant women
A
because of increase plasma volume
11
Q
wbc in pregnant women
A
10,5 million
12
Q
leading nonobstetric cause of postpartum death
A
thromboembolic disease
13
Q
hb < 11 in pregnant woman
A
it’s pathologic
14
Q
respiratory in pregnant women(2)
A
high alveolar and arterial P02
decrease alveolar and arterial PCO2
15
Q
kidney function in pregnancy(2)
A
dilation of the collecting system
high GFR
16
Q
Skin changes in pregnancy (3)
A
spider angiomas
palmar erythema
hyperigmentation
17
Q
quid of chloasma in pregnancy
A
hyperpigmentation of the face
18
Q
diastasis recti in pregnancy
A
separation of rectus muscles in the midline
19
Q
weight gain during pregnancy
A
25 a 35 lbs
20
Q
kilocalorie needed /day
A
300 kcal/day
21
Q
supplement during pregnancy
A
1 mg acide folique
iron 30- 60 mg par jour
22
Q
importance of folic acid
A
to prevent neural tube problem
23
Q
Nagele’s rule or due date
A
last menstrual period+nine months +seven days
24
Q
MAternal alpha feto protein date pour screenMSAF
A
15-20 weeks
25
who produce alpha feoto protein
baby
26
quid of High AFP
> 2,5 MoMs
27
cause of high AFP(6)
```
neural tube defects
abdominal wall dec=fect
multiple gestation
fetal death
incorrect gestationnal dating
placental abnormalities
```
28
quid of abdominal wall defect(2)
gastrochisis
| omphalocel
29
quid of neural tube defect(2)
spina bifida
| anencephaly
30
low AFP
< 0,5 Mom
31
next step denvant low AFP
rule out chromosomal abnormalities
32
role of triple screen
to detect chromosomal abnormalities
33
elements in triple screen(3)
Bhcg
estriol
MSAF
34
triple screen high
trisosmie 18
35
triple screen in down
low AFP
low estriol
high BHCG
36
best test to detect trisomies
triple test
37
indication of amniocentesis(2)
> 35 ans et grossesse
| to evaluate lung maturity
38
mature lung
lecithin/sphingomyeline> ou egal 2,5
39
time to perform amniocentesis
15 -17 semaines
40
risk in amniocentesis(2)
maternal hemorrage
| fetal loss
41
disavantages of chorionic villus sampling(2)
1% risk of fetal loss
| inability to dx neural tube defects
42
latent phase of labor
entre 3 et 4 cm
43
first stage of labor(2)
latent
| active
44
active labor
4 cm to complet dilation
45
duration of latent phase in primi
6-11 h
46
duration of latent phase in multi
4-8 hrs
47
duration of active phase in primi(2)
4-6 h
| 1,2 cm par heure
48
duration of active phase in multi(2)
2-3 hres
| 1.5 cm par heure
49
prolongation of active phase
cephalopelvic disproportion
50
second phase of labor
complete dilation to delivery of baby
51
second phase in primi duration
0,5 a 3 h
52
second phase in multi duration
5 a 30 mn
53
third phase
from delivery of infant to delivery of the placenta
54
third phase in primi and Multi
0-0,5 h
55
profil biophysique Test the Baby MAN
```
Tone fetal
Breathing fetal
Movement fetal
Aminiotic fluid
Nonstress test
```
56
hyperglycemia in the first trimester quid of that
diabete in Mom
57
Dx of gestationnal diabetes
fasting serum glucose>126 mg/dl
random glucose> 200
abnormal glucose challenge test> 140
58
when perform screening for gestationnal diabetes
24 -28 semaines
59
test routinely used to screen gestationnal diabetes
glucose challenge test
60
next step if glucose challenge test is > 140(confirmation)
3 hour glucose tolerance test
61
value to confirm gestationnal diabetes in 3 hour glucose tolerance test(4)
fasting > 95
one hour>180
2 hours> 155
3 hours> 140
62
maternal complication of diabete type 2(8)
```
DKA (type 1) or HHNK (type 2) Macrosomia
Preeclampsia/eclampsia
Cephalopelvic disproportion
Preterm labor
Infection
Polyhydramnios
Postpartum hemorrhage
Maternal mortality
```
63
fetal complication of gestationnal diabetes(11)
```
Macrosomia
Cardiac and renal defects
Neural tube defects (e.g., sacral agenesis)
hypocalcemia
Polycythemia
Hyperbilirubinemia
Intrauterine growth restriction (IUGR)
Hypoglycemia from hyperinsulinemia
Respiratory distress syndrome (RDS)
Birth injury (e.g., shoulder dystocia)
Perinatal mortality
```
64
Gestational hypertension quid
idiopathic hypertension without significant proteinuria (< 300
mg/L)
65
when gestationnal hTA begins(3)
second half of pregnancy,
during labor, or
within 48 hours of delivery
66
can a patietn patient with gestationnal HTA develops preecclampsia
yes
67
Chronic hypertension(2)
before conception and at < 20 weeks of gestation
| or may persist for > 12 weeks postpartum
68
effect negatif of ACE I on mother
uterine ischemia
69
quid of oligoamnios
amniotic fluid index
| (AFI) < 5 on ultrasound
70
etiologies of oligoamnios(3)
fetal urinary tract abnormalities
chronic uteroplacental insufficiency
ROM
71
urinary tract abnormalities assocciated with oligoamnios(3)
renal agenesis,
polycystic kidney disease,
GU obstruction
72
categorisation of preecclampsia
Mild
| severe
73
Mild precclampsia
BP > 140/90 on two occasions
| > 6 hours apart
74
proteinuria in mild precclampsia
Proteinuria > 300 mg/24 hrs
75
severe precclampsia
BP > 160/110 on two occasions > 6 hours apart
76
proteinuria in severe preecclampsia
Proteinuria > 5 g/24 hrs
77
alcool teratogenicity
fetal alcohol syndrome
78
quid of fetal alcohol syndrome(5)
```
microcephaly,
midfacial hypoplasia,
mental retardation,
IUGR,
cardiac defect
```
79
Cocaine teratogenicity(3)
Bowel atresias,(jejunal)
IUGR,
microcephaly
80
Streptomycin teratogenicity(2)
CN VIII damage/
| ototoxicity
81
Tetracycline teratogenicity(4)
Tooth discoloration,
inhibition of bone growth,
small limbs,
syndactyly.
82
Sulfonamides teratogenicity
Kernicterus.
83
Quinolones teratogenicity
Quinolones Cartilage damage.
84
Isotretinoin teratogenicity(4)
Isotretinoin Heart and
great vessel defects,
craniofacial dysmorphism,
deafness.
85
Iodide teratogenicity(3)
Congenital goiter,
hypothyroidism,
mental retardation.
86
Methotrexate teratogenicity(3)
\CNS malformations,
craniofacial dysmorphism,
IUGR.
87
DES teratogenicity(3)
Clear cell adenocarcinoma of the vagina/cervix,
genital tract abnormalities
cervical incompetence.
88
genital tract abnormalities of DES(3)
cervical hood,
T-shaped uterus
hypoplastic uterus
89
Thalidomide teratogenicity(5)
```
Limb reduction (phocomelia),
ear and nasal anomalies,
cardiac and lung defects,
pyloric or duodenal stenosis,
GI atresia.
```
90
Coumadin teratogenicity(4)
Stippling of bone epiphyses,
IUGR,
nasal hypoplasia,
mental retardation.
91
ACEIs teratogenicity(2)
Oligohydramnios,
| fetal renal damage.
92
Lithium teratogenicity(2)
Ebstein’s anomaly,
| other cardiac diseases.
93
Carbamazepine teratogenicity(4)
Fingernail hypoplasia,
IUGR,
microcephaly,
neural tube defects
94
Phenytoin teratogenicity(5)
```
Nail hypoplasia,
IUGR,
mental retardation,
craniofacial dysmorphism,
microcephaly
```
95
Valproic acid teratogenicity(3)
Neural tube defects,
craniofacial and
skeletal defects.
96
quid of polyhydramnios
AFI > 20
97
etiologies of polihydramnios(6)
```
maternal DM,
multiple gestation,
isoimmunization,
pulmonary abnormalities
twintwin transfusion syndrome.
fetal anomalies
```
98
fetal anomalies causing poplihydramnios(3)
duodenal atresia,
tracheoesophageal fistula,
anencephaly
99
pulmonary abnormalities causing polyhydramnios
cystic lung malformation
100
4 parameters to consider in intrauterine growth restriction
Biparietal diameter
Head circumference
Abdominal circumference
Femur length
101
symmetric growth restriction
all for parameters are affected
102
asymmetric growth restriction
only abdominal circumference is decreased
103
time of insult in symmetric growth restriction
early in pregnancy
104
time insult in asymmetric growth restriction
late in pregnancy
105
etiology in symmetric growth restriction
fetal problem
106
fetal problem causing symmetric growth restriction(3)
Cytogenetic
Infection
Anomalie
107
etiology in asymmetric growth restriction
Placenta mediated:
108
placental problem causing asymmetric growth restriction(3)
Hypertension
Poor nutrition
Maternal smoking
109
preecclampsia in the first trimester
mole hydatiforme
110
genotype of complete mole
46XX
111
genotype of incomplete mole
69XXY
112
particcularity of incomplete mole
contain fetal tissue
113
clue for mole hydatiform(4)
first-trimester uterine bleeding (most common), hyperemesis gravidarum,
preeclampsia/eclampsia at < 24 weeks,
uterine size greater than dates
114
ultrasound of mole hydatiform(complete)
snowstorm
115
what to avoid during mole hydatiform
preventbpregnancy for one year
116
quid of mole hydatiform
fertilization of an empty ovum
117
quid of third trimester bleeding
after 20 weeks
118
most common cause of 3 trimester bleeding(2)
Preavia
| abruptio placentae
119
3 types of preavia
Total: Placenta covers cervical os.
Marginal: Placenta extends to margin of os.
Low-lying: Placenta in close proximity to os.
120
Total praevia
Placenta covers cervical os
121
Marginal praevia
Placenta extends to margin of os.
122
Low-lying praevia
Placenta in close proximity to os.
123
C-section indication in placenta praevia(5)
```
persistent labor,
life-threatening bleeding
fetal distress,
documented fetal lung maturity,
36 weeks’ GA.
```
124
complications of abruptio
hemorragic shock
DIC
fetal hypoxia
Recurrence risk is 5–16%
125
probability for having abruptio after 2 episode of abruptio
25%
126
complication of placenta previa(7)
```
risk of placenta accreta.
Vasa previa
premature rupture of membranes
preterm delivery
IUGR
congenital anomalies.
Recurrence risk is 4–8%.
```
127
the most common fetal malpresentation
breech presentation
128
3 types of breech
Frank breech (50–75%):
■ Footling breech (20%):
■ Complete breech (5–10%): Thighs and knees are flexed.
129
frank breech
Thighs are flexed and knees are extended.
130
footling breech
One or both legs are extended below the buttocks.
131
Complete breech
Thighs and knees are flexed.
132
failure to progress in prima in latent phase
> 20 h
133
failure to progress in multi in latent phase
> 14 h
134
failure to progress in active phase
Active Failure to have progressive cervical change
| after reaching 3–4 cm.
135
arrest of fetal descent in primi
> 3 h
136
arrest of fetal descent in multi
> 2 h
137
post partum hemorrage
> 500 mL of blood for vaginal delivery or
| > 1000 mL after C section
138
Maternal factors for C section(4)
Prior classical C-section
Active genital herpes infection
Cervical carcinoma
Maternal trauma/demise
139
most common cause of C section
CPD
140
fetal and maternal factors for C swection(5)
```
Cephalopelvic disproportion
Placenta previa/
placental abruption
Failed operative vaginal delivery
post date pregnancy(relative)
```
141
fetal factors for C section(4)
fetal malposition
fetal distress
cord compression
erytroblastose fetalis
142
fetal malposition for c section(3)
posterior chin
transverse lie
shoulder presentation
143
post partum infection
≥ 38°C for at least two of the
| first ten postpartum days (not including the first 24 hours)
144
most common cause of post partum hemorrage
uterine atony
145
3 causes of post partum hemorrage
UTERINE ATONY
GENITAL TRACT TRAUMA
RETAINED PLACENTAL TISSUe
146
causes of uterine atony(4)
```
Uterine overdistention
Exhausted myometrium
Uterine infection.
Conditions interfering with
contractions
```
147
cause of uterine over distension(3)
macrosomie
multiple gestation
polyhydramnios
148
causes of exhausted myometrium(2)
prolonged labor
| oxytocin stimulation
149
Conditions interfering with
| contractions(3)
anesthesia,
myomas,
MgSO4
150
genital tract trauma causing post partum bleeding
Inadequate episiotomy repair.
Large infant.
Operative vaginal delivery
Precipitous labor
151
quid of operative vaginal delivery(2)
vacuum
| forceps
152
cause retained placental tissue(5)
```
Previous C-section/curettage.
Preterm delivery.
Uterine leiomyomas.
Placenta previa
Placenta accreta/increta/percreta
```
153
rx of uterine atony(4)
uterine massage
oxytocin
methergin
prostin(PGF 2@)
154
cause of post partum fever 7 w
```
Womb
(endomyometritis)
Wind (atelectasis,
pneumonia)
Water (UTI)
Walk (DVT, pulmonary
embolism)
Wound (incision,
episiotomy)
Weaning (breast
engorgement,
abscess, mastitis)
Wonder drugs (drug
fever
```
155
rx of mastitis(2)
antibio
| continue breasfeeding
156
complete abortion
all POC are expelled
| OS is closed
157
incomplete abortion
some POC expelled
| OS is open
158
threatened abortion(2)
No POC expelled
| OS is closed
159
nevitable abortion(3)
bleeding
No POC expelled
OS is open
160
Missed abortion(3)
No POC expelled
Pregnancy has ceased to develop
Os is closed
161
quid of reccurent abortion
> ou egal a 2 consecutives spontaneous abortions
162
what to evaluate in reccurent abortion(2)
karyotyping of both parents
| incompetent cervix
